Kate Spade’s death shines light on alarming increase in suicide rates. ©2018 CBS Interactive Inc. All Rights Reserved.

NEW YORK — The Centers for Disease Control and Prevention (CDC) put out an alarming report Thursday on suicide. Nearly 45,000 Americans took their lives in 2016, more than those who died in car accidents or opioid overdoses. The issue is receiving heightened attention after designer Kate Spade took her own life this week.

A medical examiner on Thursday determined Kate Spade, 55, died from suicide by hanging.

“It’s about mental illness,” said writer Dorri Olds, who said she understands what Spade must have been feeling.

The 56-year-old says she tried to commit suicide multiple times before getting help.

“Even with the best intentions, I don’t think Kate could have snapped herself out of it,” Olds said. “When you’re suicidal, you’re not thinking about anybody else, and it’s not because you’re selfish, it’s because you’re not well.”

Family and friends remember one Kate Spade, but the light that shined through for the cameras came with a darker side behind closed doors that many did not know or understand. Her husband, Andy Spade, said, “There was no indication and no warning that she would do this” and that his wife “was actively seeking help for depression and anxiety over the last 5 years.”

Kate Spade’s father said he spoke to her the night before she died.

https://t.co/3NMYAz8osr

— Jericka Duncan (@Jerickaduncan) June 8, 2018

The CDC study released Thursday shows half of the country has seen a more than 30 percent increase in suicide rates from 1999 to 2016. Among women, 45- to 64-year-olds have the highest rate.

Approximately half of those who committed suicide did not have a known mental health condition. And for those who did, “circumstances such as relationship problems, job/financial or physical health problems … contributed to their suicide,” the report said.

In Spade’s case, her husband says the two had been living apart for the last 10 months.

“Any life stressors that are weighing on someone who has a history of or is currently struggling with their mental health — that’s a person who you have to be worried about,” said psychiatrist Catherine Birndorf.

Birndorf says she hopes Spade’s suicide brings awareness you can’t always see.

“I hope people pay attention to those around them,” Birndorf said. “That if they see someone who is suffering or acting unlike themselves or despairing, hopeless, withdrawing from social activities that they check in on them. They make sure that they are getting the help that they need.”

The report says suicide is rarely caused by a single factor. It suggests many deaths, follow relationship problems substance use or financial issues. Experts say talking to a professional and getting help is the first step toward preventing suicide.

For immediate help if you are in a crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is available 24 hours a day, 7 days a week. All calls are confidential.

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Author and political activist Jennifer Finney Boylan has been busy as she continues to raise awareness and spread acceptance for the transgender community.

“What is a transsexual Republican, anyway? The answer, of course, is someone who thinks a little too much about their private sector.” — Jennifer Finney Boylan

Long before Jeffrey Tambor and “Transparent” or Bruce Jenner on Diane Sawyer, there was trailblazing writer and political activist Jennifer Finney Boylan.

Boylan has been a guest on TV and radio shows, including “The Oprah Winfrey Show” (four times!), “Larry King Live,” “Today,” the “Barbara Walters Special” and a documentary on CBS News’ “48 Hours.” So it is no surprise that Boylan is in great demand for speaking engagements; this month alone, she has had three biggies.

Boylan is the author of 13 books including “She’s Not There: A Life in Two Genders,” a memoir that became the first bestseller written by a transgender author. She is a contributing writer for The New York Times Opinion page, and her articles have appeared in way too many top magazines to list here. Boylan’s books include three memoirs, three novels, a collection of short stories and six young adult novels. And, as if that isn’t enough, she is currently the inaugural Anna Quindlen writer-in-residence at Barnard College.

She was born James Boylan in 1958, and 30 years later, she married Deirdre “Deedie” Boylan and had two sons. In 2000, Boylan very publicly began her male-to-female transition. Her marriage has stayed strong and intact, and Boylan has played a huge role in educating the public about acceptance and support for the transgender community.

“The last year … has been remarkable in the changes that we’ve seen in the culture. We’ve seen Jeffrey Tambor in ‘Transparent’ [and] we’ve seen Laverne Cox on the cover of Time Magazine.” — Jennifer Finney Boylan

Following is a roundup of what Boylan’s been up to this month, including snippets of her never-ending inspiration.

There was an enthusiastic roar from the crowd for Boylan after she opened her keynote speech at ASJA at the Roosevelt Hotel in New York. It was a foreshadowing to the standing ovation she would receive at the end. Her speech, “Connecting Hearts: Storytelling & Social Change,” began:

“When I do events like this and speak to people, I often think back to a reading I gave at a bookstore in Martha’s Vineyard, now many years ago, when ‘She’s Not There’ first came out [2003]. As some of you know, Martha’s Vineyard is small. There are only two bookstores on the island, so I was going to give a reading at one of them … It was a beautiful day, and I spent the day riding a bike, then [I] show up at the bookstore … and there’s the owner of the bookstore with this kind of depressed, sad expression, and I said, ‘Why the long face?’ She said, ‘Wouldn’t you know, at the last second, [the other bookstore] scheduled a reading at this exact time.’ Of course, I thought, who is going to see that when they can come see me? She said, ‘It is Hillary Clinton,’ which made me think that the only people that would come to my reading would be transsexuals and Republicans. And, in some cases, transsexual Republicans, which raised the question, what is a transsexual Republican, anyway? The answer, of course, is someone who thinks a little too much about their private sector.”

The crowd went crazy.

Freelance journalist Randy Dotinga, the first openly gay ASJA president since the organization’s inception 67 years ago, told the room, “Jenny’s message is crucial for independent writers. As freelancers and authors, we often get distracted by the day-to-day grind and forget we hold tremendous power as storytellers. Our work can transform the world for the better.”

I was especially moved by Boylan’s remarks about feeling suicidal when she was younger. I can relate. Our reasons were different but, like Boylan, I, too, would like to tell my younger self, “It will get better. It will not always hurt the way it does.” At the end of the speech, with a tear in my eye, I told Boylan how much she inspires me. She gave me her warm, radiant smile, and we chatted for a while despite the long train of other people who wanted to thank her, too.

This year’s 26th Annual GLAAD Media Awards were held at the Waldorf Astoria in New York. These awards recognize and honor the media for its fair, accurate and inclusive representations of the LGBT community and the issues that affect their lives. The awards also fund GLAAD’s work to amplify stories from the LGBT community that build support for acceptance. While introducing “Transparent” stars Judith Light and Jeffrey Tambor, and in celebration of Mother’s Day, Boylan described her coming-out conversation with her mother.

“So, there I was, in the house I’d grown up in, coming out as transgender to my 85-year-old mother, an evangelical Christian, a Republican, a nice suburban lady who did needlepoint and drove a Lexus. She didn’t know the difference between a transgender woman and the Trans-Siberian railroad. I kind of had a feeling that my coming out as trans wasn’t going to be the high point of her week. Quite frankly, I had a strong suspicion that she wasn’t going to want to know me any more.

“When I started to cry, however, my little mother got up out of her chair and put her arms around me and said, ‘I would never turn my back on my child. I will always love you. It doesn’t matter to me if you’re gay, or lesbian, or, well, whatever you are. The important thing is this: Love will prevail.’

“And I said, ‘But Mom, won’t it be embarrassing for you when everyone finds out I’m your daughter now?’ And she said, ‘Well, quite frankly, yes. But I will adjust.’

“Later that night, as I headed for bed, she kissed me and said, ‘You need to tell your story. Because no matter what, it’s impossible to hate anyone whose story you know.’”

“My mother passed away five years ago at the age of 94, still Republican, still an evangelical Christian and forever a transgender ally.”

On Friday, I asked WTCI faculty member Anne Wennerstrand to describe the organization’s mission statement. “The WTCI is evolving as an Institute to respond to the needs of non-binary, gender-variant communities via our professional training programs, workshops and lectures for the public,” she replied.

On why Boylan was chosen as this year’s speaker Wennerstrand said, “We have an annual tradition of honoring Laurie Phillips, a beloved faculty member who died of breast cancer in 1995. As an organization dedicated to mental health, we also have an equally strong commitment to social justice and equality. Each year, we honor notable feminist thinkers and practitioners who have made significant contributions to our notions of gender. We invited Jenny this year to honor her for her advocacy, feminism and unwavering dedication to civil rights.”

Wennerbrand then shared the WTCI’s definition of feminism. “To practice feminism is to believe in basic human and civil rights and equality for all regardless of gender. Jenny, through writing and advocacy embodies the definition of social justice. Jenny expands our knowledge, but more importantly, our hearts and helps us understand how to be true allies for feminism and the trans community.”

“Through her writing and speaking, Jenny [Boylan] helps raise awareness of the extremely high suicide risk and other vulnerabilities of trans youth.” — Anne Wennerstrand, Faculty member, WTCI

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Wish I could blame nuclear weapons, a mutant virus or Hitler for the malformation in my Russian Jewish bloodline, but my theory is a suicide gene. That coupled with an inability to bond during difficult times. We held our sorrow separately, a silent pact—if we didn’t put words to it, nothing was awry. With a child’s vocabulary I tried to convey the dark storms in my head, but felt my efforts swept aside. “What the hell does that kid have to be depressed about?” Dad asked. Mom shushed him. I was unglued and my family found me exhausting.

But, I wasn’t the only spooked member of the herd. June 1973, my sister Jenny was fifteen, I was twelve. At dinner, Mommy said, “Please pass the peas.” As Jenny picked up the bowl I stared at her white-bandaged wrists.

“Does it hurt?” I asked softly.

She turned her head down to her plate, her lip quivered.

“A little,” she whispered.

 “Anybody want another Tab?” Mom asked. Before anyone answered, she disappeared into the kitchen.

In our Long Island home generations of ancestors marched in photo display up the foyer walls. I spent hours staring at what a perfect family we appeared to be—Ma, a bestselling self-help author, who looked like Jackie O in jeans, Dad, a radio man with Sinatra’s angular cheekbones and straight white teeth. People often said, “None of you look Jewish.” It was a backhanded compliment meaning we had nice noses and frizz-free hair.

Later that same year, 1973, I stepped on the third rail of the Long Island Railroad and nothing happened. So I stepped on it again. I was under the impression it would electrocute me instantly.

“Hey Kid.” a station worker called out. “You could get yourself killed.”

Next day in Science I asked a classmate, “Hypothetically, what would happen if I accidentally stepped on the third rail?”

“Nothing.” he said. “You’re wearing sneakers. Rubber can’t conduct electricity.”

At fifteen, in 1975, I ran away via the same train rails. Back to my native Manhattan, I’d absconded to escape despair and shake off suburbia. In Greenwich Village I found my Mardi Gras and became a street urchin. One day at West Fourth Street, I jumped a turnstile. While I fled from a cop, the subway tunnel summoned me. The iron rails promised an instant solution to loneliness—death. I looked back to see who or what I was running from. Then, magnetically pulled toward my dead heroes, Jimi and Janis, I jumped down onto the subway tracks in front of an oncoming train. Steel hurtled at me with the promise of ramming, crunching, killing. At the speed of that E train, it hit me I could be maimed and live. Existence would be far worse as an amputee. I squeezed tight against the wall. Blast of horn and screech of metal blew out my eardrums while manic swirls of grit choked off my breath. After the train passed, I followed the rails to the nearest exit and kept running.

Years later, shrinks attributed my morbidity to low levels of serotonin and poor impulse control. My dopamine receptors didn’t light up. That is, until I poured drugs and alcohol on them. Too bad Mom’s bestselling parenting books didn’t have all the answers. Both of us wished she knew what to do. I was missing the brain piece that signals enough. I might have learned to compensate for my genetic predisposition if anti-depressants had been the Tic-Tacs they are today.

In 1977, when I was seventeen, Mom’s brother Carl shot himself in the heart. He died before he fell back on his bed. Ma was angry. Words like selfish and thoughtless circled the air until she put the kibosh on that topic.

Last night, I googled my gene theory—if one family member tried to off themself were others more likely to try? The overwhelming proof shone on my monitor like a spiritual white light. I’d never known how to explain my self-destruction before. Questions regarding my suicidal tendencies seemed as cockamamie as asking me why was I allergic to cats.

At seventeen I was in a car crash. Three died and I almost did too. For years I’d prayed to God to get me the hell out of here, but clearly he’d aimed and missed. Apparently, my envy for the three dead was a peculiar response. Along with other deficiencies, I was told I lacked gratitude. Mom and Dad took me to doctors who fixed my broken bones. My reaction to this miraculous recovery was to guzzle Quaaludes, Valiums and vodka, then I laid down and waited to exit in repose. With no note it would appear accidental, nobody could ever label me selfish. But after two days I popped up again like the egg-shaped toy in a popular commercial, Weebles wobble but they don’t fall down. My response? I took to shooting up coke.

In 1983, more family woes. Dad’s sister wrapped a plastic bag around her head. Her sons were livid but relieved they found her in time. When we got the news, Dad slammed the Arts section down and said, “Jesus H. Christ.”

But it wasn’t all a grim deathwatch waiting for who was going to drop next. There were happy times. Dad worked in radio and cracked us up with on-air bloopers like the Princeton cheerleaders making a big “P” on the field. Ma framed my artwork and gave great birthday parties. At Broadway plays we all sat in orchestra seats.

I remember Ma’s soft hands against my forehead when I was sick. But more vivid is how our hard heads rammed into each other. Brutal words we couldn’t take back, scenes we could not rewind. My rebellion became predictable. I found life and everyone in it unacceptable. It wasn’t a fear of death that disturbed me, it was being stuck here endlessly spiraling down. I ached for a connection more intimate than my Washington Square dealer, but alcohol, amphetamines and acid consumed all of my trust and devotion. 

At 26, in a typical drunken haze, I wept. In my MacDougal Street apartment I cried for Jenny’s scarred wrists, poor Uncle Carl and my own failed attempts. I groped in the dark through ashtrays and bottles, dialed the phone and woke up in rehab. Too late for a do-over, I trudged through twenty years of therapy, the twelve steps and countless chocolates. I sold my first painting, opened a business, got my first dog. In 1994, I bought a one bedroom in Chelsea. By 2003 I’d paid it off. I treated Ma and Dad to dinners and orchestra seats. After years of breakups and a heart like ground chuck, I stopped picking what-was-I-thinking men and finally fell in love. Mine was a quick success story, it only took forty years.

Watching Rise of the Planet of the Apes recently, my adrenalin pumped at the thrill from bloodshed. I laughed at my continued fascination with death—bookshelves packed with true crime, OD’d rockers magnets on the fridge, prayers for the new season of Dexter to start—and the occasional urge to poke a bobby pin into the wall socket just to see what would happen.

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As a native New Yorker, I have practically zero attention span, yet I read Face to Face in one sitting. The opening line grabbed me by the throat and wouldn’t let go. Casey’s book tells the harrowing tale with no self-pity or whining. It is straightforward storytelling. When I spoke with Casey she said, “I wanted to tell what happened and how people can survive and even thrive after a thing like that.”

In November it will be 16 years since the incident. Chris is now a happy and likeable wisenheimer. During our interview, when I asked how he felt about his mother’s book, Chris said, “I told her if it didn’t do well I wasn’t going to shoot myself again.” Involuntarily, I burst out laughing. “It hurt too much the first time,” he said. “Anyway, the doctor told me I was too hard-headed to die.”

Humor and willfulness is what got him through his long, painful recovery. On that fateful night Chris had gone to his soon-to-be ex wife’s house and they’d had a fight. She’d yelled, “I could care less whether you live or die.”

“I thought, I’ll show her.” Chris said. He and his wife had a two-year-old son at the time, and he had a three-month-old daughter with his girlfriend, Megan.

“I grew up without a father,” Chris told me. “If I had only thought it through I wouldn’t have done it. I would’ve realized that I’d be leaving my kids—who I loved so much—without a father. But that night I felt like I was no good to anybody and they’d all be better off without me. I went to my Step-Dad’s gun cabinet and grabbed a 12-gauge hunting rifle. I was a big guy, hard to control, so when my Mom tried to stop me, I pushed her to the floor.”

Chris said he then drove to a store, bought shotgun shells, went to his estranged wife’s backyard and shot himself. He said the blast went in a vertical line through his chin and missed his brain. His eyes and hearing were spared but his face was gone. The chin, jaw, mouth, teeth, nose, and part of his tongue were all destroyed and he’d lost three quarters of his blood by the time the paramedics arrived. He was assumed dead until one paramedic saw he was still breathing.

“I found out later,” Chris said, “that the shotgun never should have gone off. The round I bought was too big for that gun. Ballistically speaking, it can’t happen. But it did. And my face collapsed.”

Chris had a total of 17 painful surgeries over a five-year period. His mom and girlfriend, Megan (who is now his wife of 15 years) were there through the entire odyssey.

In the book, Casey described  her arrival at the scene. The police wouldn’t let her go near him. “I knew from the way everyone was acting, the situation must be grave.” My heart broke for her all over again every time we spoke.

One thing about the story made no sense to me. I couldn’t understand how his girlfriend, Megan, had made the choice to stay with him. When I asked her she said, “I had no idea until that night that he still wanted to be with his wife. At the time, we had a three-month-old daughter and we’d already planned to marry. After he shot himself I was full of disdain. Lots of anger. I felt like he’d killed my boyfriend,” Megan said. “But I stayed for the sake of our daughter. It took a couple of years before I was healed enough to love and trust again. But after those first few years, I fell in love with this ‘other’ man, who looked nothing like the man I’d fallen in love with.”

Chris still has prominent scars on his face. After studying old photos, I commented on how handsome he’d been. “I’m still damn handsome!” he said.

“You’d be surprised how common these types of injuries are,” said Upper East Side plastic surgeon, Dr. Thomas Romo, III. “In the past, a patient with devastating damage to the midface would go through 15–20 operations, then endure enormous pain for long periods of time.”

That was Chris’s route. His first surgery lasted thirty hours. Then he had 16 more. I wondered how his mother could have afforded all of the medical bills. Chris told me that the first six weeks were covered by his insurance. After that he received disability from the State. Insurance paid to build him a mouth but then refused to put teeth in it—they said dentures were cosmetic. Casey was saddled with the bills that weren’t covered.

After waking up in the hospital, Chris said, “I felt embarrassed but learned to deal with it. The nurses wouldn’t let me have fingernail clippers or anything. I wanted to go home and had no idea why I couldn’t. I was on so many painkillers I didn’t understand what was happening. After six weeks in the hospital, they let me see what I had done.”

Chris said, “I never felt as bad as I did that night.” Being constantly laid up and recovering he had a lot of time to think. “I saw how many people really loved me. It was then I made up my mind to stop living a selfish life.” The self-will that nearly destroyed him was transformed into a determination to help others.

“It’s been a rewarding life, maybe not financially but emotionally. I’m happily married, my wife and I laugh all the time. I love my kids and I coach wrestling and baseball. I’m more than just coach, I’m part Dad to all the kids. I make sure they keep their grades up and they know I’m there when they need me. I never focus on the past, only the future.”

Because the shooting didn’t affect his ears and eyes he said, “I hear and see better than most people. But I’ll be 40 this year so I need reading glasses.”

The memoir left me with the feeling that there is almost nothing a person cannot rise above. It made my daily “problems” of short deadlines, inflation, lousy subway service and bad cab drivers seem frivolous.

To order the book Face to Face visit the author’s website.

This story appeared in the New York Resident magazine, August 2011.

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